| Ll Provider Inc | |
|
12668 Chapman Ave Unit 2107 Garden Grove CA 92840-4037 | |
| (949) 861-0127 | |
| Not Available |
| Full Name | Ll Provider Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 12668 Chapman Ave Unit 2107, Garden Grove, California |
| Authorized Official Name and Position | Lorna Logan (FOUNDER) |
| Authorized Official Contact | 9498610127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ll Provider Inc 12668 Chapman Ave Unit 2107 Garden Grove CA 92840-4037 Ph: (949) 861-0127 | Ll Provider Inc 12668 Chapman Ave Unit 2107 Garden Grove CA 92840-4037 Ph: (949) 861-0127 |
| NPI Number | 1871206300 |
|---|---|
| Provider Enumeration Date | 12/29/2022 |
| Last Update Date | 12/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871206300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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